Accelerating Vaccine Adaptation for the Frontier
Market-shaping strategies can push and pull firms to accelerate the adaptation of vaccines for fragile, complex, and challenging health systems, reducing waste, improving access and quality, and ultimately saving lives. They bridge epidemiology and economics to help make the world a more just and healthy one. In 2013 we supported MSF's ACCESS Campaign in its mission to do just that through the development of a political-economic history of vaccine manufacturing and a theory of change for accelerating the adaptation of vaccines today.
THE IMPERATIVE TO ADAPT
Poor countries have had access to vaccines developed for richer health systems, those with excellent infrastructure and resources, through differential pricing and pooled procurement for generations. The vaccines themselves have never been appropriate for the hardest-to-reach, most vulnerable populations and more temperature-stable, easy to handle and administer vaccines could help close those gaps. But as rich and poor market disease burdens diverge, and donor funds reduce, poor countries can hardly depend on continuing this approach to prevent and control infectious disease. Adapting vaccines not just for the operational contexts of weak systems, but also the epidemiology and ability to buy, is both mission critical and a nascent opportunity for pharmaceutical companies and countries alike.
We conducted a systematic literature review, market research and key-informant interviews with representatives from local and global NGOs and multi-laterals, country governments, foundations, regulators, industry, and academia.
The paper drew from theory in industrial organization, research-and-development, business economics, and epidemiology to provide frames on a systematic review of grey literature from major institutions in the global immunization system and case studies across all phases of industry.
THEORY OF CHANGE
To fundamentally change the way vaccines are developed, produced, and commercialized for adaptation will require the global immunization system of donors, countries, partners, and manufacturers to change the way they characterize, assess, and manage value (outcomes divided by costs). This begins with better information systems and analytics, and integrated communications with industry, from target product profiles and prequalification processes to tenders and post-market surveillance.